Aged Care and Other Legislation Amendment Act 2025 (45 of 2025)
Schedule 1 Amendment of the Aged Care Act 2024
Part 1 Amendments commencing immediately after the commencement of the Aged Care Act 2024
Aged Care Act 2024
165 Sections 250 and 251
Repeal the sections, substitute:
250 Payment of subsidy
(1) Subsidy is payable by the Commonwealth to a registered provider if:
(a) the registered provider is eligible for subsidy under section 191, 201, 209 or 218 for a funded aged care service delivered to an individual on a day; and
(b) the registered provider gives the System Governor a claim for that subsidy in accordance with section 251.
Note: Subsidy is not payable to the extent that there are insufficient funds in an individual's relevant notional account: see section 251A.
(2) Subsidy payable in relation to individuals to whom funded aged care services were delivered through each service delivery branch of a registered provider is separately payable by the Commonwealth.
(3) If the full amount of subsidy for which a registered provider is eligible under section 191, 201, 209 or 218 for a funded aged care service delivered to an individual on a day is not payable because of the previous operation of section 251A in relation to the subsidy, the registered provider remains eligible for so much of the full amount of subsidy as remains unpaid.
Note: If additional credits are made to the individual's relevant notional account or the registered provider's relevant notional service delivery branch account, the unpaid amount may become payable in accordance with subsection (1) if an additional claim is made for that unpaid amount.
251 Claims for subsidy
(1) For the purposes of obtaining payment, a registered provider must give to the System Governor a claim, in an approved form, for any subsidy that is payable, for the relevant period for the subsidy, to the registered provider under section 250 for a funded aged care service delivered to an individual through a service delivery branch of the registered provider during the relevant period.
(2) The relevant period is:
(a) for person-centred subsidy for an ongoing funded aged care service delivered to an individual through the service group home support - a quarter; and
(b) for provider-based subsidy for an ongoing funded aged care service delivered to an individual through the service group home support - a financial year; and
(c) for subsidy for a short-term funded aged care service delivered to an individual through the service group home support - the maximum period of effect for the individual's classification level for the classification type for the service group; and
(d) for subsidy for ongoing funded aged care services delivered to an individual through the service group assistive technology - the period prescribed by the rules; and
(e) for subsidy for short-term funded aged care services delivered to an individual through the service group assistive technology or home modifications - the maximum period of effect for the individual's classification level for the classification type for the service group.
(3) The claim must be given to the System Governor before the end of:
(a) whichever of the following periods ends first:
(i) the period of 60 days after the end of the relevant period;
(ii) the period of 60 days after an event prescribed by the rules occurs; or
(b) if the System Governor determines a longer period for the claim than would otherwise apply under paragraph (a) - that longer period.
Note: Because the claim must be given before the end of the period applicable under this subsection, it can be given at any time before the end of that period, including during the relevant period
(4) The System Governor must approve the claim for any subsidy that is payable to the registered provider, and give the registered provider a payment summary relating to the claim, as soon as reasonably practicable after the claim is given to the System Governor under subsection (1), unless the System Governor gives a written notice under section 252 to the registered provider in relation to the claim (which deals with registered providers who are not eligible).
(5) To avoid doubt, for the purposes of this section:
(a) multiple claims can be made for a single relevant period; and
(b) claims for multiple days in the same relevant period can be included in a single claim; and
(c) a further claim may be made for an unpaid amount referred to in subsection 250(3).
251A Subsidy amounts not payable to the extent of insufficient funds
Person-centred subsidy for home support
(1) Despite subsection 250(1), subsidy for which a registered provider is eligible under section 191 for the delivery of a funded aged care service to an individual on day is payable only to the extent that, immediately before the claim for the subsidy is approved, the amount worked out at Step 1 of the method statement in subsection 192(1) or 192(2) (the debit amount ) in relation to the subsidy does not exceed:
(a) the available balance of the individual's notional ongoing home support account or notional short-term home support account (as applicable) for the quarter or account period (as applicable) in which the day occurs; or
(b) if there is an excess amount - the excess amount (as reduced (but not below zero) by the sum of any reduction amounts referred to in Step 2 of the method statement in subsection 192(1) or 192(2) and the available balance of any unspent Commonwealth portion held by the provider for the individual) does not exceed the available balance of any notional home care account for the individual.
Provider-based subsidy for home support
(2) Despite subsection 250(1), subsidy for which a registered provider is eligible under section 201 for the delivery of a funded aged care service to an individual on a day is only payable to the extent that, immediately before the claim for the subsidy is approved, the amount worked out at Step 1 of the method statement in section 202 (the debit amount ) in relation to the subsidy does not exceed the available balance of the registered provider's notional service delivery branch account for the service branch through which the service was delivered for the financial year in which the day occurs.
Person-centred subsidy for assistive technology or home modifications
(3) Despite subsection 250(1), subsidy for which a registered provider is eligible under section 209 or 218 for the delivery of a funded aged care service to an individual on a day is only payable to the extent that, immediately before the claim for the subsidy is approved, theamount worked out at Step 1 of the method statement in section 210 and 219(the debit amount ) in relation to the subsidy as reduced (but not below zero) by the available balance of any unspent Commonwealth portion held by the registered provider for the individual:
(a) does not exceed the available balance of any notional home care account for the individual; or
(b) if there is an excess amount - the excess amount (as reduced (but not below zero) by the sum of any reduction amounts referred to in step 2 of the method statement in section 210 or 219) does not exceed the available balance of the individual's notional assistive technology account or notional home modifications account.
251B Debiting of notional accounts and unspent Commonwealth portions
Person-centred subsidy for home support
(1) If the System Governor approves a claim relating to subsidy for which the registered provider is eligible under section 191 for the delivery of a funded aged care service to an individual on a day, the following must be debited, in the following order, to cover so much of the debit amount referred to in subsection 251A(1) that is payable under that subsection:
(a) the individual's notional ongoing home support account or notional short-term home support account for the quarter or account period in which the day occurs;
(b) any unspent Commonwealth portion held by the provider for the individual;
(c) the individual's notional home care account (if any).
Provider-based subsidy for home support
(2) If the System Governor approves a claim relating to subsidy for which the registered provider is eligible under section 201 for the delivery of a funded aged care service to an individual on a day, the registered provider's notional service delivery branch account for the service delivery branch through which the service was delivered for the financial year in which the day occurs must be debited to cover so much of the debit amount referred to in subsection 251A(2) that is payable under that subsection.
Person-centred subsidy for assistive technology or home modifications
(3) If the System Governor approves a claim relating to subsidy for which the registered provider is eligible under section 209 or 218 for the delivery of a funded aged care service to an individual on a day, the following must be debited, in the following order, to cover so much of the debit amount referred to in subsection 251A(3) that is payable under that subsection:
(a) any unspent Commonwealth portion held by the provider for the individual;
(b) the individual's notional home care account (if any);
(c) the individual's notional assistive technology account or notional home modifications account.
Debiting of unspent Commonwealth portions
(4) To avoid doubt, an unspent Commonwealth portion held by a registered provider for an individual is required to be debited under this section if the portion has reduced an excess amount referred to in paragraph 251A(1)(b) or the debit amount as referred to in subsection 251A(3).
Note: If additional credits are made to the individual's relevant notional account or the provider's relevant notional service delivery branch account, the unpaid amount may become payable in accordance with subsection 250(1) if an additional claim is made for that unpaid amount.